Inspection on 30/11/07 for 239 Boxley Road

This inspection was carried out on 30th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

239 Boxley Road 19/12/06

239 Boxley Road 18/10/05

239 Boxley Road 14/06/05

239 Boxley Road 08/10/04

239 Boxley Road 26/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 239 Boxley Road Maidstone Kent ME14 2BG Lead Inspector Eamonn Kelly Key Unannounced Inspection 30th November 2007 10:30 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 239 Boxley Road Address Maidstone Kent ME14 2BG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager Type of registration No. of places registered (if applicable) 01622 764979 01622 686457 yes.oshea@invictanet.co.uk Mrs Lorna O`Shea Mr Sean O`Shea Vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th December 2006 Brief Description of the Service: All residents have single bedrooms on the ground floor, first and second floors. There are extensive communal facilities. The home receives additional professional support through the owners company that runs 9 properties (not regulated by the commission) in the Maidstone area for supported living. This community support service currents supports some 73 people within 9 properties. These properties house residents financed by Supporting People and Kent County Council. Fees are as follows: 1. Weekly fees are £566 to £824. 2. Residents meet the following costs from their own resources: • • • • • • • • • • • • Hairdressing. Magazines, DVD’s. Personal audio-visual equipment. Chiropody. Use of the payphone. Cost of meals out. Clothes and toiletries. Cost of some activities (e.g. entrance fees). Holiday costs. Additional costs for holidays in some circumstances (e.g. proportion of staff costs for holidays abroad). Transport costs [e.g. taxi fares, 38p per mile when transported in private cars, contribution for journeys made in vehicles owned by the supported living business]. All other personal spending. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 30th November 2007. This consisted of meeting with the manager (Deborah McNair), general manager (Karina Matthews), members of staff and residents. Care practices were observed and discussed with members of staff, residents and visitors. A variety of records were seen during the visit principally those that supported the care of residents. The manager provided the commission with an annual quality assurance assessment (AQAA). The report contains no requirements or recommendations. Excellent lifestyle support is provided to residents. What the service does well: What has improved since the last inspection? Some of the achievements during 2007 are: • • • • • • Increased staffing ratios identified as necessary to enable new activities and higher levels of support. Additional pictorial communication systems. Review of client goals for the coming year based on those previously met. Higher levels of interaction with medical professionals to address increasing support needs of some residents. Closer liaison with social service’s care managers and community nursing for the continuing protection of residents Review of hygiene and infection control measures to protect residents when unrelated medical conditions are diagnosed. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 6 • Staff team restructure to help residents receive the types and level of support they need and focussed training in this regard. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Prospective residents and their representatives receive advice and guidance, as part of detailed pre-admission assessments, to enable them to decide with confidence if the home is likely to meet their support needs. EVIDENCE: A full assessment of potential client’s is carried out. There is liaison as necessary with care managers, nurses and others. A transition period appropriate to the needs of the individual is agreed which includes at least six visits and an overnight stay. Progress is assessed and determined through regular client meetings and keyworker involvement. Clients can choose their own decorations and furniture. Care is taken to ensure that the home provides furniture and fittings including replacements over time in accordance with appropriate national minimum standards in this regard. Client’s general capabilities and associated aspirations are identified at this time. Families are closely involved with every step of the procedure. A personal contract is prepared for each new resident. There is also a written contract with the placing local authority. Personal contracts and the resident 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 9 guide have been improved to ensure that these cover all necessary information needed by clients, families and other representatives. The procedure is lengthy and detailed to ensure as far as is practicable that existing and prospective resident’s rights and requirements are met and maintained. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents are able to make decisions about how to lead their lives and they each have relatively independent lifestyles. EVIDENCE: A care plan record containing good information, including a typed and updated personal profile, is kept for each resident. These contain general information and also specific details of resident’s support needs and how these are being met. Individual plans contain narratives supported by pictures and script that charts the lifestyles of residents. Each resident has his/her set of activities and routines. The manager has broadened the range of activities available depending on capabilities and preferences of residents. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 11 Residents are involved in making decisions about what happens at the home and about how they spend their time. Previously residents had progressed to the extent that they were able to move to an independent living scheme. The manager’s key objective is to develop and maintain the independence of residents. They continue to lead busy lives. In the examples discussed and with reference to pictorial records and methods of communication, there is evidence of improvement in the ways residents live their lives communicate how they feel. The annual quality assurance assessment (AQAA) outlines how resident’s personal goals and aspirations are met. The methods used are person centred planning and care plan updating, key-worker reports, client meeting minutes, review reports and incident reports. As part of quality assurance measures, a key procedure involves determining client goals for the coming year based on achieving the ones previously set. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17. People who use the service experience excellent quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents have excellent opportunities for leisure and personal development. EVIDENCE: Each resident has an agreed programme that, in relevant circumstances, includes access to education, leisure opportunities and personal development. These opportunities and activities are available within and outside the premises. Resident’s interests and capabilities are assessed and initial activities are agreed. These have been reviewed and revised over the past year. The capabilities and aspirations of each resident are continuously assessed to enable each to progress further. Residents receive assistance from staff to follow agreed routines. This involves encouragement with household tasks, cooking, maintaining bedrooms and 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 13 using personal audio-visual equipment. Communal resources are available for residents to use. A resident has exclusive use of a garage to store items of value and personal interest. This forms part of his development plan. Shops and pubs are within walking distance. The town centre is nearby so leisure centres, cinemas and restaurants are easily visited. Some residents make regular use of the owner’s craft centre that is a few minutes walk of the home. At this location they receive skilled tuition from craft specialists and they meet people there who live at the owner’s supported living scheme premises in Maidstone. Residents are closely involved in choosing where they go on holiday including taking holidays abroad. The catering manager uses a Food Standards Agency information pack to keep track of food hygiene measures. This included a recommended FSA diary, risk assessment procedure, and method of keeping a cleaning rota. She helps residents to use the kitchen. This is to both enable them to have routine involvement in the home’s activities and for planned personal development. There are constant menu reviews, meal theme days and integration of resident’s likes and dislikes in meal provision. The annual quality assurance assessment (AQAA) states that clients are helped to be involved in a variety of valuable and meaningful activities that meet their social, educational, vocational and religious needs. Plans for the future include further promotion of equality and diversity. It is possible that a website will be created to enable the manager and general manager to highlight their service to minority communities. The AQAA also suggests a new focus on varied inhouse activities for clients less able to access outside activities for medical reasons. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents receive good personal and healthcare support. EVIDENCE: There is an increasingly high level of interaction with various appropriate health professionals because of the changing needs of some residents. The AQAA refers to the significant changing personal care needs of residents that are addressed with understanding helped by the level of training staff have received from health professionals. The AQAA refers to the steep learning curve in the understanding by staff of resident’s complex medical conditions. The commission was informed of developments throughout 2007. Profiles of residents discussed during the inspection and observation of some aspects of life at the home, indicated that residents receive excellent personal and healthcare support. Over the past year, the commission was informed by the manager and general manager of how the health of residents is protected including where very serious health conditions are faced by residents. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 15 Members of staff have a good knowledge of the types of conditions experienced by residents. The manager and a client attended a GP’s conference to update GPs on the difficulties experienced in obtaining oxygen the client requires. The manager and staff constantly re-assess how best to help residents cope with their physical and other conditions. Aspects of communication observed during the inspection visits confirmed that members of staff are knowledgeable about how to meet each resident’s personal health challenges. An important aspect includes how the catering manager helps residents enjoy life at the home. The circumstances surrounding the death and funeral of a resident two years ago indicate that members of staff are able to provide support for residents who are seriously ill. Regular medication audits are completed on the recording, storage, and administration of medications. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents and their representatives are involved in all aspects of life at the premises and residents are protected from abuse. EVIDENCE: Members of staff are aware of their duty to recognise if residents are subject to any forms of abuse and they know how to report suspected instances. Each member of staff is aware of how to contact social services or the commission if circumstances existed where they felt that the owners or manager could not be initially alerted. The revised resident’s guide contains a plain and straightforward outline complaint’s procedure. The manager is aware of the two ways that POVA is referred to. Firstly, that the Dept of Health POVA Manager must be informed if any member of staff is dismissed or suspended in circumstances relating to the safety or continuing well being of residents. Secondly, the home provides training on aspects associated with the protection of vulnerable adults (PoVA) including an appropriate level of tuition during the induction process and how suspected abuse should be identified and reported. There are regular and transparent communications with the commission and care managers where concerns arise about the protection and support of clients. Staff are aware of the local authority Safeguarding Adults policy and 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 17 associated procedures. They know how these have changed significantly during 2007. Complaints are addressed and outcomes are recorded. Incident reports are maintained. Issues are discussed in a transparent way during staff/client meetings and minutes are kept. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28, 30. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. The premises are suitable for the support of residents. Members of staff and residents should have the benefit of proper clothes drying facilities. EVIDENCE: All residents have single bedrooms. Apart from one bedroom on the ground floor, the rest are on the first and second floors. Three bedrooms have ensuite facilities. There are sufficient communal bathroom facilities. The ground floor bathroom is the one most used by residents. Most residents lock their bedroom doors. Each personalises his/her room. The owner provides furniture specified under current national minimum standards for each resident. Where residents bought cupboards and other furniture, the manager maintains a record in the resident’s personal file to make sure that residents are not encouraged to buy furniture and fittings. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 19 The AQAA outlines how hygiene and infection control measures are observed with diligence due to various unrelated medical conditions having been diagnosed that necessitated this. Clinical waste services have also been reviewed. Kitchen hygiene is kept at a high standard. Good laundry facilities are needed due to increasing incontinence. Proper clothes drying facilities (currently lacking) are needed to progress this important objective. The AQAA outlines improvements to premises earlier in the year, for example, bathroom decorated in marine colours by residents, refurbishment of downstairs bathroom, quiet room redecorated, some bedrooms repainted and more storage facilities for in-house activities. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. The staff group supporting residents receives relevant training and opportunities for personal development. EVIDENCE: Recruitment procedures include a full application form completed by applicants, two references taken up, CRB/POVA checks undertaken, probationary periods, induction and supervision. An up-to-date spreadsheet is available for inspection showing the name of each member of staff, the CRB (criminal records bureau) reference number, date and outcome of the check. As well as the manager and general manager, there are 2 senior support workers, five support workers, night staff, four bank staff, and catering manager. Staff have opportunities to undertake NVQ training and other training to enable them to understand and meet the needs of clients. They receive regular formal supervision. The AQAA refers to the benefits of staff meetings. The manager is preparing a personal development profile for each member of staff. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 21 Senior support workers are gradually taking more responsibility for on-call duties. With some longer-term members of staff leaving, additional staff hours linked to changing client needs and arrival of new staff underline the importance of staff development measures. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. People who use the service experience good quality outcomes. This judgement was made using a range of evidence including a visit to the service. Residents and members of staff have the benefit of living/working in a residential home that is well conducted. EVIDENCE: The manager has relevant qualifications and experience in the provision of residential support. There are effective quality monitoring systems. These have the overall objective of providing a relaxed and homely environment for residents. The quality assurance assessment provided to the commission by the manager effectively delineates the current and changing directions of care inputs for residents. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 23 Contact between the commission and Mrs McNair and Mrs Matthews and evidence of their close co-operation with care and health professionals indicates a high level of clear and open communication. This is of benefit to staff, residents and relatives. There is good recording of events about resident’s health and welfare and report writing is to a high standard. Members of staff receive good support, direction and instruction. Residents are involved in all aspects of activities within the premises and outside. There are advanced communications systems being developed for helping clients to remain involved. The AQAA contains a declaration about the maintenance of important equipment. A resident outlined how she takes part in interviewing potential members of staff and she has an important role in health and safety matters including fire safety procedures. 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 239 Boxley Road DS0000023869.V353134.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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